Monday

31


August , 2020
Special care needed to challenge malnutrition in Covid 19 phase
12:22 pm

Kishore Kumar Biswas


 

Malnutrition refers to deficiencies, excess or imbalances in a person’s intake of energy and/or nutrients. There are two broad categories here: the first includes undernutrition. Undernutrition includes stunting, that is low height for age and wasting or low weight for height. There are other two factors in the group - underweight or low weight for age and micronutrient deficiencies that refer to a lack of important vitamins and minerals.

Malnutrition in India

A major factor responsible for malnutrition is poverty. On the basis of the World Bank’s estimates of extreme poverty defined by $1.9 per capita per day estimate assessed at the 2011 purchasing power parity, India’s poverty has declined from 45.9 % in 1993 to 13.4% in 2015. This is a noteworthy achievement.

It was thought that if India could almost eliminate poverty by 2030 and continue with its growth trajectory - the country would emerge as a global leader. But during the last seven years, the performance of the economy has not been impressive. At present, the total food grain stock of the government (about 76 MT in one estimate) is more than twice our statutory requirement. As there has been a National Food Security Act where 67% of the population are under a subsidised food distribution system, it is hard to believe that India would not reach the target even before the targeted 2030.

The Global Nutrition Report 2020 published last May pointed out that India is among the 88 countries that are likely to miss the global nutrition targets by 2025. It also identified that India has one of the highest rates of domestic inequalities in malnutrition. Some of the targets of the World Health Organisation to be met by 2025 have been to reduce stunting by 40% in children under five years of age, reduction of anaemia by 50% among women between 19-49 years, ensuring 30% reduction in low birth weight, increase the rate of breastfeeding in the first six months up to at least 50% and reduce childhood wasting to less than 5%.

In India, 37.9% of children aged less than five years are stunted and 20.8% are wasted as compared to Asia’s average of 22.7% and 9.4% respectively. India is identified as among the three highest waste countries along with Nigeria and Indonesia. At the same time, its levels vary four-fold across communities. In this context, one should note that the United Nation’s Sustainable Development Goals aim to end all forms of hunger and malnutrition by 2030.

Malnutrition in India in the Covid-19 episode

The impact of malnutrition has been more intense during the Covid-19 period. First, after the announcement of the lockdown, Anganwadi centres were closed. Therefore, the different children-centric services were not available. Secondly, the mid-day meal programme, which has been a primary source of supplementary nutrition for millions of school-going students has been highly disrupted due to closure of schools in spite of certain attempts that were undertaken by the state governments. Thirdly, an established programme serving hot cooked food under the Integrated Child development Scheme (ICDS) at villages and urban slums has been severely disrupted. Both the central and state governments are trying to supply staple food, vegetables and fruits and trying to ensure distribution of take-home ration under the ICDS programme. In this situation, there is a huge possibility to divert - a part of the food - to non-targeted sections. Fourthly, to tackle the Covid-19 pandemic, ASHA and Anganwadi workers are also being engaged in various Covid 19 related jobs which is impacting their routine work.

The UNICEF reportedly warned in its report that 1.2 million additional children under five could die in just six months in low and middle-income countries. This was linked to possible reduction in routine health services coverage and increase in child wasting. One of the largest death tolls could be from India. At this stage, apart from a government directed approach, a community-based approach is also needed to combat the situation.       

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